| Project/Area Number |
12671414
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Orthopaedic surgery
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| Research Institution | Osaka University |
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Principal Investigator |
SUGANO Nobuhiko Osaka University Graduate School of Medicine, Lecturer, 医学系研究科, 講師 (70273620)
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| Co-Investigator(Kenkyū-buntansha) |
OCHI Takahiro Osaka University Graduate School of Medicine, Professor, 医学系研究科, 教授 (80112035)
NISHII Takashi Osaka University Graduate School of Medicine, Assistant Professor, 医学系研究科, 助手 (70304061)
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| Project Period (FY) |
2000 – 2003
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| Project Status |
Completed (Fiscal Year 2003)
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| Budget Amount *help |
¥2,700,000 (Direct Cost: ¥2,700,000)
Fiscal Year 2003: ¥700,000 (Direct Cost: ¥700,000)
Fiscal Year 2002: ¥700,000 (Direct Cost: ¥700,000)
Fiscal Year 2001: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 2000: ¥700,000 (Direct Cost: ¥700,000)
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| Keywords | Osteonecrosis of femoral head / T2^*-weighted dynamic MRI / Apoptosis / Disorder of microcirculation / Alendronate / Tacrolimus (FK-506) / Organ transplantation / Multiple osteonecrosis / 特発性大腿骨頭壊死症 / 核磁気共鳴画像 / 3D-MR volume registration / 修復 / 心臓移植 / 腎移植 / 急性拒絶反応 / 膠原病 / ステロイド / 多発性骨壊死症 / 骨シンチグラム / 虚血性発現蛋白 |
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| Research Abstract |
We evaluated femoral perfusion in a non-traumatic rabbit serum sickness osteonecrosis model, using serial repetitive T2^*-weighted dynamic MRI and contrast enhanced MRI. The results indicated that microcirculatory disorder proceeded to histological osteonecrosis. Using the TUNEL reaction in rat with osteonecrosis, we have studied the death mechanism of the cell involved in osteonecrosis. The mechanism of cell death was apoptosis, which showed that apoptosis was not cause of osteonecrosis. In the prospective MRI studies of renal transplant patients, no bone marrow edema proceeding to band patterns was observed, which indicated that bone marrow edema would not be the cause of osteonecrosis of the femoral head (ONFH) in renal transplant patients. A cohort study was done, to compare the effect of two immunosuppressive agents, cyclosporine A and tacrolimus, in terms of the development of ONFH after renal transplantation. The risk of ONFH was reduced in the patients who used tacrolimus for i
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mmunosuppression. Whether ONFH could reduce or not during the natural course was investigated using a novel developed procedure named 3D-MR volume registration. The results showed some early necrotic lesions could reduce in size. We also evaluated long-term reparative process of osteonecrosis with minimum 10-years radiological follow-up and MRI at final examination, necrotic lesions without collapse except for early lesions did not show any sigh of progression of repair process. It was proved that lesion size and location were important prognostic indicators of collapse using novel three-dimensional indexes. We performed the first clinical trial, which showed significant preventing effect of collapse development by administration of alendronate. MRI screening for multiple osteonecrosis (MON) was performed in patients with ONFH. MON was found in about a half of steroid or alcohol related ONFH but none of idiopathic ONFH, which showed steroid-related or alcohol related ONFH are a systemic disease. Less
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